右美托咪定复合阿芬太尼在老年高血压患者内镜逆行性胰胆管造影术中的临床效果及对氧化应激的影响

Clinical effect of Dexmedetomidine combined with Alfentanil in elderly hypertensive patients undergoing endoscopic retrograde cholangio-pancreatography surgery and the effect on oxidative stress level

目的探讨右美托咪定复合阿芬太尼在老年高血压患者内镜逆行胰胆管造影术中的临床效果及对氧化应激的影响。方法选取2022年1月至8月江西省赣州市人民医院收治的60例行内镜逆行胰胆管造影术治疗的老年高血压患者作为研究对象,采用随机数字表法将其分为对照组(30例)和观察组(30例)。对照组患者采用丙泊酚+阿芬太尼,观察组患者采用右美托咪定+阿芬太尼。比较两组患者围手术期的相关指标,麻醉前(T_(0))、麻醉诱导后(T_(1))、检查镜过咽喉部(T_(2))、手术开始后10 min(T_(3))、手术结束(T_(4))的平均动脉压和心率,比较两组患者麻醉前后血清超氧化物歧化酶活性水平、丙二醛含量以及不良反应总发生率。结果麻醉前,两组患者平均动脉压、心率比较,差异均无统计学意义(P>0.05);麻醉后,观察组T_(1)时平均动脉压高于对照组,T_(2)~T_(4)时的平均动脉压均低于对照组,差异有统计学意义(P<0.05)。观察组T_(1)~T_(4)时的心率均低于对照组,差异有统计学意义(P<0.05)。术毕观察组超氧化物歧化酶活性水平高于对照组,丙二醛含量低于对照组,差异有统计学意义(P<0.05)。观察组术中不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定复合阿芬太尼在维持血流动力学稳定、抗氧化应激、减少呼吸抑制方面效果佳,安全性好,且无明显不良反应。

Objective To explore the clinical effect of Dexmedetomidine combined with Alfentanil in elderly hypertensive patients undergoing endoscopic retrograde cholangio-pancreatography(ERCP)surgery and the effect on oxidative stress level.Methods A total of 60 elderly hypertensive patients with ERCP surgery in Ganzhou People's Hospital from January to August 2022 were selected as the research objects,and they were divided into control group(30 cases)and observation group(30 cases)by random number table method.The control group was treated with Propofol+Alfentanil,and the observation group was treated with Dexmedetomidine+Alfentanil.Relevant indicators,mean arterial pressure(MAP)and heart rate(HR)before anesthesia(T_(0)),after induction of anesthesia(T_(1)),examination of the scope over the pharynx(T_(2)),10 min after the start of surgery(T_(3))and at the end of surgery(T_(4))were compared between the two groups.The serum superoxide dismutase(SOD)activity levels,MDA levels before and after anesthesia,and the total incidence of adverse reactions were compared between the two groups.Results There were no significant differences in MAP and HR between the two groups before anesthesia(P>0.05).The MAP of T_(1) in observation group was higher than that in control group,while the MAP of T_(2)-T_(4) were lower than those in control group after anesthesia,the differences were statistically significant(P<0.05).The HR of T_(1)-T_(4) in observation group were lower than those in control group,the differences were statistically significant(P<0.05).The SOD of the observation group were higher than that in control group,while the MDA were lower than those in control group after operation,the differences were statistically significant(P<0.05).The total incidence of adverse reactions of the observation group was lower than that in control group,the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine combined with Alfentanil is effective in maintaining hemodynamic stability,anti-oxidative stress and reducing respiratory depression,with good safety and no significant adverse effects.